Conran Joseph

Stellenbosch University | SUN · Division of Physiotherapy

Objective To assess the readiness of healthcare institutions that serve as clinical platforms for Stellenbosch University’ rehabilitation students, and to explore the opinions of rehabilitation professionals regarding the integration of telerehabilitation (TR) into service delivery and students clinical training. Methods This study employed a qual...

Objectives: To examine convergent and divergent validity of the King's Parkinson's disease Pain Scale - Swedish translated version, and to determine the prevalence of pain according to scale domains in persons with Parkinson's disease. Design: Cross-sectional, validation study. Patients: Ninety-seven persons with Parkinson's disease. Methods:...

Background: Spinal cord injuries typically result in a range of negative health outcomes and health states, which impacts overall functioning, health and well-being. It remains important to establish the prevalence (burden) of health outcomes to help with the development of optimal treatment strategies. Objectives: To determine the prevalence an...

Objective: The objective was to describe the individual items of the environmental factors and to investigate the relationship between the environmental factors to health conditions, general health and quality of life in people with SCI in South Africa. Methods: Two hundred persons with SCI participated in a cross-sectional survey design. This s...

Study Design: A prospective, open-ended, cohort study design. Objectives: To determine the incidence, etiology and injury characteristics of traumatic spinal cord injury (TSCI) in Rwanda. Setting: All referral hospitals within the Republic of Rwanda. Methods: All survivors of acute TSCI who met the inclusion criteria were prospectively recruited fo...

Chronic pain amongst individuals with traumatic and nontraumatic spinal cord injury (SCI) has high prevalence rates, with severe impact on the activities of daily living, mood, sleep and quality of life. This study aimed to explore the experiences and challenges of chronic pain management amongst the traumatic spinal cord injury (TSCI) population i...

Research on adolescent refugee resilience is crucial for understanding the mechanisms of adaptation to resettlement areas and integration into a new country. However, the current literature does not provide clear evidence on the determinants of resilience factors and the association between traumatic experiences and resilience among adolescent refu...

Purpose The unemployment rate post spinal cord injury (SCI) in South Africa is high with limited knowledge of environmental factors outside the health services, especially in an unevenly developed resource setting like South Africa, affecting the employment rate in people with SCI. Our purpose was to investigate factors associated with employment i...

Rationale: South Africa has a high traumatic injury burden resulting in a significant number of persons suffering from traumatic brain injury (TBI). TBI is a time-sensitive condition requiring a responsive and organized health system to minimize morbidity and mortality. This study outlined the barriers to accessing TBI care in a South African town...

This scoping review examines known associations between potential traumatic experiences and mental health outcomes among adolescent refugees. Little is known about the type and severity of traumatic experiences among adolescent refugees and whether the type and severity of these experiences are associated with poor mental health. Five electronic da...

Objective: To scope all published information reporting on the feasibility, cost, access to rehabilitation services, implementation processes including barriers and facilitators of telerehabilitation (TR) in low- and middle-income countries (LMICs) and high-income countries (HICs). Methods: A comprehensive electronic search of PubMed, Scopus, PE...

This study assesses the influence of process and injury factors on motor and sensory recovery following traumatic spinal cord injury (tSCI).

Introduction Much is known around public health preparedness and response phases. However, between the two phases is operational readiness that comprises the immediate actions needed to respond to a developing risk or hazard. Currently, emergency readiness is embedded in multiple frameworks and policy documents related to the health emergency cycle...

Objectives: To describe the three-month prevalence and correlates of self-reported physical health conditions in persons with spinal cord injury (SCI) worldwide. Study design: Multinational cross-sectional survey. Subjects: Community living persons with traumatic or non-traumatic SCI aged > 18 years from 21 countries representing all the six Wor...

Background Telerehabilitation, i.e. rehabilitation at a distance using Information and Communication Technology (ICT), is a promising avenue for improving health among people with neurological diseases or older adults who often experience limited access to services. Still, little is known about physiotherapists’ use, perceptions and needs with reg...

Background: Telerehabilitation is an emerging segment of telehealth and telemedicine that has a potential to deliver quality, accessible, cost-effective and efficient rehabilitation services where geographical distance is a critical factor. The objectives of this review are: to describe the feasibility and cost-effectiveness of telerehabilitation,...

Objectives To determine the influence of employment, injury characteristics and living situation on psychosocial reintegration in individuals who sustained a traumatic spinal cord injury (TSCI) in South Africa. Design A cross-sectional exploratory survey. Settings Communities of the Cape Metropolitan Area, South Africa. Participants A total of 1...

Background: Undergraduate (UG) education of rehabilitation professionals requires research methodology (RM) modules. Unfortunately, (1) these modules are often separated into individual programmes within the different academic divisions, prohibiting the development of a critical mass of practice-ready workforce with the potential to strengthen the...

Purpose Accelerometry measurements are a promising method to provide quantitative information of upper limb function in daily life post stroke. Our purpose was to investigate i) the validity of accelerometer-based vector magnitude ratios (VMR) to distinguish upper limb function between individuals post-stroke and healthy controls during ambulatory...

Background Spinal Cord Injury (SCI) rehabilitation programs are cognitively demanding, requiring patients to acquire knowledge and new skills while adjusting to their profoundly altered physiology. Evidence from high income countries (HIC) has shown that SCI is associated with cognitive dysfunction, which is linked to poorer rehabilitation outcomes...

Background Spinal cord injury (SCI) rehabilitation is cognitively demanding, requiring patients to aquire new skills and knowledge while adjusting to profoundly altered physical function. There is growing evidence for an association between SCI and cognitive dysfunction, where physiological factors, such as concommitantly sustained traumatic brain...

Background Knowledge of health system indicators are essential to the living situation of persons with disabilities. Assessing and collating the performance of health systems is important in order to identify areas of improvement. The main aim of this study is to assess the relationship between health system indicators and self-reported quality of...

Objective To examine relationships between age and spinal cord injury (SCI) and cause of SCI, and how this depends on economic development. Design Cross-sectional survey. Setting Community, 22 countries representing all stages of economic development. Participants 12,591 adults with SCI. Interventions Not applicable. Main Outcome Measures Inte...

Spinal cord injury (SCI) almost always results in a decrement in functioning over the lifespan. With the lack of specialized SCI services in low- to middle-income countries and the trend of shorter stays in rehabilitation facilities following SCI, a definite need exists to empower clients to manage themselves, often while they await critical servic...

Objectives: As advancing evidence on modifiable resources to support mental health in persons experiencing physical disabilities is of particular importance, we investigate whether structural and functional social relationships relate to mental health in people with spinal cord injury (SCI). Methods: Data from 12,330 participants of the Internation...

Background Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging a...

Objectives To assess perceived levels of community reintegration, and examine whether self-efficacy relates to community reintegration among persons with a TSCI. Design A cross-sectional exploratory survey. Settings Cape Metropolitan Area. Western Cape Province, South Africa. Participants A hundred and eight (108) conveniently selected community...

A Correction to this paper has been published: https://doi.org/10.1038/s41394-020-00369-z

Purpose: To identify contextual factors and injury characteristics influencing the quality of life (QoL) among individuals who sustained a traumatic spinal cord injury (TSCI) in South Africa. Materials and methods: We carried out a cross-sectional survey to examined the influence of contextual factors and injury characteristics on quality of lif...

Qualitative descriptive study with inductive thematic content analysis. To explore how individuals living with paraplegia in South Africa experience sex and intimacy and how they perceive the related health services and support they received whilst adapting to life post injury. Community based in Cape Town, South Africa. Purposive and snowball samp...

Objective: To provide prevalence estimates for problems in functioning of community-dwelling persons with spinal cord injury (SCI) and to examine associations between various areas of functioning with the purpose of supporting countries in identifying targets for interventions. Design: Cross-sectional survey. Setting: Community, 22 countries i...

Study design: A prospective, regional, population-based study. Objectives: (1) Determine the mortality rate and factors associated with it 4 years after a TSCI and (2) The point prevalence of secondary medical complications of survivors at 4 years. Setting: Communities of the Cape metropolitan area, South Africa. Methods: All persons (n = 14...

Background: Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging...

Background: Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging...

Background: Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging...

Objective (1) To determine associated factors of improved balance performance after a 10-week HiBalance intervention period, and (2) to determine effects of the programme on modifiable factors found above, considering both groups. Design Pre-posttest substudy founded on the outcomes evaluation of an effectiveness-implementation trial. Participant...

Background To describe and present detailed protocol of a systematic review aimed at determining available research evidence regarding the intensity, and frequency of Task-Specific Training that can best result in improved motor function, and mobility outcomes in both upper and lower extremities in acute, sub-acute and chronic stroke survivors. Met...

Background This study aimed to describe and present detailed protocol of a systematic review aimed at determining available research evidence regarding the intensity, and frequency of task-specific training ( TST ) that can best result in improved motor function and mobility outcomes in both upper and lower extremities in acute, sub-acute and chron...

Background Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging a...

Background: Little is known about physical activity (PA) in people with stroke living in low-income areas. The aim of this study was to characterize and contrast the levels and patterns of PA between stroke survivors with different ambulation status living in low-income areas in Cape Town, South Africa. Methods: In this cross-sectional study, 45 co...

Background: Parkinson's disease (PD) is a devastating neurodegenerative disorder. Reduced balance is one of the cardinal symptoms of PD, predisposing people living with PD to experience difficulties with the execution of tasks and activities, as well as hindering their involvement in meaningful life areas. The overarching aim of this study was to...

Background Parkinson’s disease (PD) is a devastating neurodegenerative disorder. Reduced balance is one of the cardinal symptoms of PD, predisposing people living with PD to experience difficulties with the execution of tasks and activities, as well as hindering their involvement in meaningful life areas. The overarching aim of this study was to ex...

Background and purpose: In order for people with Parkinson disease (PwPD) to benefit from neurorehabilitation research, interventions tested in research settings require assessment in real-world clinical practice. There is little evidence for whether efficacious exercise interventions for PwPD remain effective when transferred to standard clinical...

Background: Parkinson’s disease (PD) is a devastating neurodegenerative disorder. Reduced balance is one of the cardinal symptoms of PD, predisposing people living with PD to experience difficulties with the execution of tasks and activities, as well as hindering their involvement in meaningful life areas. Objective: The aim of this study was to ex...

The aims of this study were to determine pain severity in persons with mild-moderate Parkinson's disease compared with healthy age- and sex-matched controls, and identify related factors, that is, demographic, disease severity, and functioning, of pain severity in the Parkinson's disease group. A cross-sectional study design was adopted to assess p...

Background Parkinson’s disease (PD) is a devastating neurodegenerative disorder. Reduced balance is one of the cardinal symptoms of PD, predisposing people living with PD to experience difficulties with the execution of tasks and activities, as well as hindering their involvement in life situations. Objective The aim of this study was to explore ho...

Objectives: (i) To determine the prevalence of secondary complications after traumatic spinal cord injury during acute care and rehabilitation; (ii) to investigate whether associations exist between level and completeness of injury and the development of common complications; and (iii) to assess whether associations exist between secondary complic...

Study design: Population-based cohort study. Objectives: To determine non-modifiable and modifiable risk indicators of acute length of hospital stay (LOHS) after traumatic spinal cord injury (TSCI). Setting: Government-funded hospitals within the City of Cape Town, South Africa. Methods: Newly injured survivors of TSCI during a 1 year period...

Introduction The upsurge in the use of clinical prediction models in general medical practice is a result of evidence based practice. However, the total number of clinical prediction rules (CPRs) currently being used or undergoing impact analysis in the management of patients who have sustained spinal cord injuries (SCIs) is unknown. This scoping...

Background and purpose: Although increasing evidence supports the benefit- of exercise among people with Parkinson disease (PwPD), it is unclear whether a given exercise modality suits all PwPD, given the heterogeneity of the disease. The purpose of this study was to explore factors associated with responsiveness to a highly challenging training i...

BACKGROUND. The epidemiology of traumatic spinal cord injury (TSCI) is poorly understood in developing countries. In South Africa (SA) specifically, two healthcare systems (private v. government funded) exist, and it is therefore important to assess patient characteristics in order to plan appropriately. OBJECTIVES. To determine epidemiological cha...

Objective: To determine the cost-effectiveness of the HiBalance training program for managing Parkinson's disease (PD)-related balance and gait disorders. Design: Cost comparison design following the randomized controlled trial comparing a novel balance training intervention with care as usual. Subjects: A total of 100 participants with mild-m...

Background: Test Instrument for Profile of Physical Ability (TIPPA) is used in the Swedish sickness certification process for patients with long-term musculoskeletal pain. The aim was to explore the content of TIPPA in the context of work-ability assessments. Methods: The full protocol of TIPPA was linked to the in relation to the International...

Background Translating evidence into practice requires adaptation to facilitate the implementation of efficacious interventions. A novel highly challenging balance training program (HiBalance) was found to improve gait, balance, and physical activity in persons with Parkinson’s disease (PD) in an earlier randomized controlled trial. This study aime...

Background: The provision of specialized care in a time-sensitive manner has shown to be crucial for survival and recovery of functioning after a traumatic spinal cord injury (TSCI). However, little is known about the provision of TSCI care in different international contexts; information which is required for strengthening policy and practice. Aim...

Objective: To investigate the feasibility of using accelerometers to monitor physical activity in persons with stroke admitted to inpatient rehabilitation. Design: Longitudinal observational study. Participants: Persons with stroke admitted to a specialized rehabilitation centre for sub-acute rehabilitation were recruited between August and De...

Purpose: To investigate objectively measured physical activity in stroke survivors living in low-income areas of Cape Town, South Africa, specifically to: (a) describe the volume of daily physical activity and time spent in different intensity levels and (b) investigate the association of factors covering the International Classification of Functio...

Abstract Background Good conceptual knowledge is an essential requirement for health professions students, in that they are required to apply concepts learned in the classroom to a variety of different contexts. However, the use of traditional methods of assessment limits the educator’s ability to correct students’ conceptual knowledge prior to alt...

Background. Spinal cord injuries (SCIs) caused by assault present a unique challenge facing the healthcare system, in that very little is known about how these injuries manifest compared with other causes of injury. Understanding the nuances of gunshot SCIs could contribute towards better care provision. Objective. To determine the characteristics...

Objectives: To update the incidence rate, aetiology and injury characteristics of acutely-injured adults with traumatic spinal cord injury in Stockholm, Sweden, using international standards of reporting. Study design: Prospective, (regional) population-based observation. Subjects: Forty-nine consecutively enrolled individuals. Methods: A su...

Background: Rehabilitation medicine plays an integral part in attainment of optimal functioning after injury or disease. The National Rehabilitation Policy of South Africa (NRP) (2000) highlights the need for access to professional health care services, redistribution and optimal utilisation of resources and research in the field of disability and...

In South Africa, epidemiological data on spinal cord injury (SCI) are scarce, partly owing to the lack of a national registry and a coordinated system of care. A recent study by Joseph et al. provided the first population estimates of the incidence of traumatic spinal cord injury (TSCI), reporting a staggering rate of 75.6 per million persons. The...

Background: Trauma to the human spinal cord typically strikes out of the blue, leaving those surviving the initial ordeal with permanent or temporary deficits in health and functioning. Because of this, traumatic spinal cord injuries (TSCI) impose a significant burden on society. While these facts are well known for certain countries, the Internati...

Background: To develop rehabilitation services promoting participation in persons living with a traumatic spinal cord injury (TSCI) is of major concern for physiotherapists. What the client sees as effective participation, barriers and facilitators might be different due to their particular context. This study was conducted in order to gain insigh...

Objective: To evaluate the extent to which the rehabilitation outcome levels (ROL) and the spinal cord independence measure (SCIM) III could be mapped to the International Classification of Functioning, Disability and Health (ICF) and the brief core set for spinal cord injury (SCI) in the post-acute context. Methods: Two professionals used the p...

Background Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed re...

Study design: Prospective, population-based cohort study. Objectives: To determine the prevalence of selected complications following traumatic spinal cord injury during acute care and to identify the risk factors for pressure ulcers. Setting: The only tertiary academic (Groote Schuur) hospital in the catchment region providing specialised acu...

Prospective, regional population-based study. To provide the incidence, aetiology and injury characteristics of traumatic spinal cord injury (TSCI) in the City of Cape Town, South Africa. All government-funded hospitals within the City of Cape Town, South Africa. All survivors of acute TSCI, given that they met the inclusion criteria, were prospect...

Determining the functional abilities and factors influencing outcome of patients with stroke following rehabilitation are essential for the planning of future interventions and services in order to optimise recovery. To determine the activity limitations and factors influencing functional outcome of patients with stroke managed at a specialised reh...

Abstract:The purpose of this study was to investigate the changes in the activity limitations of patients following in-patient rehabilitation and the factors influencing functional ability as measured by the Spinal Cord Independence Measure III (SCIM III). A longitudinal study design was utilised to study the change in functional abilities of patie...